| Replantation of total avulsed scalp with microsurgery: experience of eight cases and literature review. | |
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MedLine Citation:
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PMID: 18332826 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Reports in the literature about scalp replantation are mostly sporadic; rarely can one find a large series. We present our experience with eight cases of scalp amputation replanted microsurgically. METHODS: From 1992 to 2003, eight patients who sustained scalp amputation injuries underwent microsurgical replantation. Age ranged from 3 to 46 years (average, 27.3), and four patients were male. The scalp amputations in the three adult male patients were sustained from cutting incidents by a blade, whereas those in the four female patients were from their long hair getting caught in a roller machine. A 3-year-old boy suffered scalp avulsion from a dog bite. A vein graft was needed in four patients whose scalp injuries resulted either from avulsion or a dog bite, which was not deemed necessary for those sustained by cutting injuries. RESULTS: Seven of the eight replantations were successful. The failed replantation in this series was the case where only arterial revascularization was performed, which resulted in venous congestion. Rotation scalp flap was placed to cover the defect. A boy who sustained scalp amputation from a dog bite suffered partial necrosis of the replanted scalp, which was covered with a skin graft. The resulting alopecia area was eventually excised after tissue expansion. CONCLUSION: Successful replantations can achieve the best esthetic and functional results compared with other procedures. Scalp amputations sustained from sharp cuts seem to be quite as common as hair traction injuries. Such amputation injuries were more common in male patients with short hair. The manner of injury often will influence planning during replantation. Even if the amputated scalp was crushed or contaminated, such as those sustained from animal bites, replantation should still proceed, unless a greater contraindication exists. |
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Authors:
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Jir-Wen Yin; Jeannette Marie S Matsuo; Ching-Hua Hsieh; Ming-Chung Yeh; Wen-Chieh Liao; Seng-Feng Jeng |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: The Journal of trauma Volume: 64 ISSN: 1529-8809 ISO Abbreviation: J Trauma Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-11 Completed Date: 2008-04-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 796-802 Citation Subset: AIM; IM |
Affiliation:
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Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Animals Bites and Stings / surgery Child Child, Preschool Female Humans Male Microsurgery / methods* Middle Aged Replantation / methods* Scalp / blood supply, injuries*, surgery* Surgical Flaps Tissue Expansion / methods |
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